Prediabetes is a metabolic condition in which blood glucose levels are higher than normal, although they do not yet meet the diagnostic criteria for type 2 diabetes.
As a result, it represents an increased risk of developing both diabetes and cardiovascular disease. Detecting this condition early makes it possible to implement preventive measures, which can delay its progression and decrease the likelihood of associated complications.
According to data from the World Health Organization (WHO), around 10% of adults worldwide have prediabetes. In Latin America, it is estimated that between 15% and 30% of adults have this condition, although many are unaware of it. Early detection can make the difference between developing diabetes and staying healthy.
Why is it important to detect prediabetes?
People with prediabetes generally do not experience specific symptoms and may remain unaware of their condition. The only way to find out is through a blood test that checks glucose levels.
If left unaddressed, between 25% and 70% of individuals with prediabetes will develop type 2 diabetes in the following years. In addition, people with prediabetes have a higher risk of developing cardiovascular diseases, even before a diagnosis of diabetes is made.
Although prediabetes itself is asymptomatic, there are a few signs that could indicate it has progressed to diabetes, such as:
- Increased thirst and frequent urination
- Fatigue
- Blurred vision
The presence of one or more of these symptoms does not confirm a diagnosis, but it should prompt a medical consultation.
Prediabetes is rarely an isolated metabolic condition
It is important to note that, in most cases, people with prediabetes also have other associated metabolic conditions or disorders, such as:
- Being overweight or obese, particularly with excess abdominal fat
- High blood pressure
- Abnormal levels of cholesterol, triglycerides, or both
This combination of these conditions is referred to as metabolic syndrome and partly explains the higher risk of cardiovascular disease in people with prediabetes.
Prediabetes occurring in isolation, particularly in someone of normal weight, or in individuals with a family history of type 1 diabetes or other autoimmune conditions requires a more thorough evaluation by a medical team.
Most common risk factors
Prediabetes is more common in certain groups, with the primary risk factors including:
- Being over 45 years of age
- Being overweight or obese, particularly with excess abdominal fat
- Sedentary lifestyle
- Family history of type 2 diabetes
- Previous gestational diabetes
- Polycystic ovary syndrome
- High blood pressure or elevated cholesterol or triglyceride levels
- Taking certain drugs, such as corticosteroids
Early diagnosis: tests and values
- Prediabetes is diagnosed through blood tests that measure fasting blood glucose levels, which usually fall between 100 and 125 mg/dL.
- Oral glucose tolerance test (2 hours): between 140 and 199 mg/dL.
- Glycated haemoglobin (HbA1c): between 5.7% and 6.4%.
If the results fall within these ranges, it is important to make lifestyle changes to help prevent progression to type 2 diabetes.
How can progression to diabetes be prevented?
The main recommendation for people with prediabetes is to adopt healthier lifestyle habits, which is the most effective intervention. Numerous studies show that taking action at this stage can reduce the risk of developing diabetes by more than 50%. The most effective strategies include:
1. Following a balanced diet
- Reduce the consumption of refined sugars and ultra-processed foods.
- Increase fibre intake (fruit, vegetables, pulses and whole grains).
- Control portion sizes and avoid frequent snacking.
2. Regular physical activity
- Aim for at least 150 minutes of moderate exercise per week (such as walking, swimming or cycling).
- Include strength-training exercises twice a week.
3. Weight loss
- For people who are overweight, losing 5–7% of their body weight can make a significant difference to their health.
- For those with obesity, a reduction of around 10% can provide even greater benefits.
4. Adequate sleep and stress management
- Chronic stress and poor sleep can affect insulin regulation.
- Ensuring at least seven hours of quality sleep each night is essential.
Medical treatment in selected cases
At present, there are no medicines officially approved to correct high blood sugar in people with prediabetes. However, several drugs used in the management of diabetes can also help lower blood glucose in those with prediabetes.
For people with prediabetes who are at high risk, especially when the condition is associated with overweight or obesity that does not improve with lifestyle changes, doctors may prescribe additional medication. This approach should always be personalised and carried out under the supervision of a healthcare professional.
In summary, prediabetes is a condition that increases the risk of developing both type 2 diabetes and cardiovascular disease. This risk is linked not only to persistently high blood glucose, but also to the metabolic disturbances that frequently accompany them. Early detection, along with measures aimed at improving metabolic control, can help reduce the risk of progression and related complications.
Regular medical follow-up is essential to monitor progress and personalise recommendations for each patient.
INFORMATION DOCUMENTED BY:
Dr Emilio Ortega, Endocrinology Department, Hospital Clínic Barcelona.
